PMT18-03462 City of Menifee Permit No.: PMT18-03462
29714 HAUN RD.
Type: Residential Re-Roof
'r MENIFEE, CA 92586
MENIFEE MENIFEE Date Issued: 07/12/2018
PERMIT
Site Address: 28712 WEE BURN WAY, MENIFEE, CA Parcel Number: 339-125-015
92586 Construction Cost: $10,000.00
Existing Use: Proposed Use:
Description of TEAR ALL EXISTING ROOF LAYERS, INSTALL NEW COOL ROOF SHINGLES
Work: `•CRRC#0676-0042 "
Owner Contractor
TOM&PEGGY MANERI ,
28712 WEE BURN WAY
MENIFEE, CA 92586
Applicant License Number:
TOM&PEGGY MANERI
28712 WEE BURN WAY
MENIFEE, CA 92586
Phone: 9512583144
Fee Description OOt r Amount fEl
Building Permit Issuance 1 27.00
Inspections not specified 98 98.00
GREEN FEE 1 1.00
General Plan Maintenance Fee-Building 1 4.90
$130.90
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors In the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_Bidg_Permit_Template.rpt Page 1 of 1
CITY OF MENIFEE
LICENSED DECLARATION property who builds or improves thereon,and who contracts for the projects
I hereby affirm under penalty of perjury that I am under provisions of with a�(icensed contractor(s)pursuant to the Contractors State License Law).
Chapter9(commencing with section 7000)of Division 3 of the Business and ;1 am exempt from Iicensure under the Contractors State License Law for
Professions Code and my license is in full farce and effect. the following reason:
License Class License No. By my signature below I acknowledge that,except for my personal residence
Expires Signature in which I must have resided for at least one year prior to completion of
improvements covered by this permit.I cannot legally sell a structure that I
WORKER'S COMPENSATION DECLARATION have built as an owner-builder If it has not been constructed in its entirety by
D I hereby affirm under penalty of perjury one of the following declarations:I licensed contractors.I understand that a copy of the applicable law,Section
have and will maintain a certificate of consent of self-insure for workers 7044 of the Business and Professions Code,is available upon request when
compensation,issued by the Director of Industrial Relations as provided for this application Is submitted or at the following website:
by Section 3700 of the Labor Code,for the performance of work for which ww inf . law.html.
this permit is issued.
Policy# _ Date
o I have and will maintain workers compensation insurance,as required by PROPERTY OW NE OR AUTHORIZED AGENT
section 3700 of the Labor Cade,for the performance of the work for which Sn' 'mmyy signature below I certify to each of the following:I am the property
this permit is issued.My workers compensation Insurance carrier and policy owner or authorized to act on the property owners behalf.I have read this
number are: application and the information I have provided Is correct.I agree to comply
Carrier with all applicable city and county ordinances and state laws relating to
building construction.I authorize representatives of this city or county to
Policy# Expires ent b ve-id tiled property for inspection purpose
�1.'�+� Ir� I� ��//))1
(This section need not to be completed is the permit is for one-hundred ` ^+ Date_�I J 1 (�
dollars($100)or less PROP RTY OWNER OR A T O EMT II
D I certify that in the performance of the work for which this permit is Issued,
I shall not emolov any persons in any manner so as to become subject to the CITY BUSINESS LICENSE#
workers compensation laws of California,and agree that if I should become HAZARDOUS MATERIAL DECLARATION
subject to the workers compensation provisions of Section 3700 of the Labor
Code,I shall forthwith comply with those provisions. Will the applicant or future building occupant handle hazardous material era
mixture containing a hazardous material equal to or greater thatthe
Applicant Date amounts specified on the Hazardous Materials Information Guide?
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS oyes DNo
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES Will the intended use of the building by the applicant or future building
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN occupant require a permit for the construction or modification from South
ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR Coast Air Quality Management District(SCAQMD)?See permitting checklist
IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES for guidelines
CONSTRUCTION LENDING AGENCY D Yes ❑No
I hereby affirm that under the penalty of perjury there is a construction Will the proposed building or modified facility be within 1000 feet of the
lending agency for the performance of the work which this permit is issued outer boundary of a school?
(Section 3097 Civil Code) ❑Yes o No
OWNER BUILDER DECLARATIONS I have read the Hazardous Material Information Guide and the SCAQMD
permitting checklist.I understand my requirements under the State of
I hereby affirm under penalty of perjury that I am exempt from the
Californiaealth al Safety Code,Section 25505 and 25534 concerning
Contractors License Law for the reason h
s)indicated below by the
checkmark(s)I have placed next to the applicable item(s)(Section 7031.5 hazardous material reporting.
Business and Professions Code).Any city or county that requires a permit to oyes o No
Date
construct,alter,improve,demolish or repair any structure,prior to its
PROPERTY OWNER OR AUTHORIZED AGENT
issuance,also requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors State EPA RENOVATION.REPAIR AND PAINTING(RRP)
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the The EPA Renovation,Repair and Painting(RRP)Rule requires contractors
Business and Professions Code)or that he or she is exempt from Iicensure receiving compensation for most work that disturbs paint in a pre-1978
and the basis for the alleged exemption.Any violation of Seaton 7031.5 by residence or childcare facility to be RRP-certified firms and comply with
an Applicant for a permit subjects the applicant to a civil penalty of not more required practices.This includes rental property owners and property
than($500). managers who do the paint-disturbing work themselves or through their
D 1,as owner of the property,or my employee with wages as their sole employees.For more information about EPA's Renovation Program visit:
compensation,will do( I all of or( )portion of the work,and the structure is www.epa.gov/lead or contact the National Lead Information Center at
not intended or offered for sale.(Section 7044,Business and Professions 1-800-424-LEAD(5323).
Code;The Contractors State License Law does not apply to an owner of a
property who,through employees'or personal effort,builds or improves the An EPA Lead-Safe Certified Renovator will be responsible for this project
property provided that the improvements are not Intended or offered for Certified Firm Name:
sale.If,however,the building or improvement is sold within one year of Firm Certification No.:
completion,the Owner-Builder will have the burden of proving that itwas
not built or improved for the purpose of sale. ❑No EPA Lead-Safe Certified Firm is required for this project because:
❑I,as owner of the property am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors State License Law does not apply to an owner of a If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Men'fee
DATE: 7/12/2018 PERMIT/PLAN CHECK NUMBER
TYPE: O COMMERCIAL ESIDENTIAL O MULTI-FAMILY O MOBILE HOME O POOL/SPA DSIGN
SUBTYPE: O ADDITION O ALTERATION O DEMOLITION O ELECTRICAL O MECHANICAL
O NEW O PLUMBING E-ROOF NUMBER OF SQUARES
DESCRIPTION OF WORK re-roof
PROJECT ADDRESS 28712 Wee Burn Way ZIP 92586
ASSESSOR'S PARCEL NUMBER 339-125-015 LOT 167 TRACT 32552
OWNER NAME Tom & Peggy Maned (TKMD Investments Ilc) City of Me
ADDRESS 1391 Lynridge Court, Riverside CA 92506 Ullding Dept.
PHONE 951.258.3144 EMAIL pc.maneri@gmail.com JUL 12 2018
APPLICANTNAME Peggy Maned
ADDRESS 1391 Lynridge Court, Riverside CA 92506
PHONE 951.258.3144 EMAIL pc.maneri@gmail.com
CONTRACTOR'S NAME OWNER BUILDER? BYES O NO
BUSINESS NAME
ADDRESS
PHONE EMAIL
CONTRACTOR'S STATE UC NUMBER LICENSE CLASSIFICATION
VALUATION$ P SQ FT 2800 L SQ FT 50
APPLICANT'S SIGNATURE DATE 7/12/2018
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PIANNING ENGINEERING FIRE ACCEPTED BY:
PERMITFEE Q` SMIP �e GREEN 1
PLAN CHECK FEE INVOICETOTAL JW CIO
OWNER BUILDER VERIFIED O YES O NO DRIVERS LICENSE# NOTARIZED LETTER O YES 0 NO
City of Menifee Building&Safety Department 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityotmenifee.us
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